Can single disease payment system based on clinical pathway reduce hospitalization costs in rural area? A case study of uterine leiomyoma in Anhui, China

Abstract Background Single disease payment program based on clinical pathway (CP-based SDP) plays an increasingly important role in reducing health expenditure in china and there is a clear need to explore the scheme from different perspectives. This study aimed at evaluating the effect of the scheme in rural county public hospitals within Anhui, a typical province of China,using uterine leiomyoma as an example. Methods The study data were extracted from the data platform of the New Rural Cooperative Medical Office of Anhui Province using stratified-random sampling. Means, constituent ratios and coefficients of variations were calculated and/or compared between control versus experiment groups and between different years. Results The total hospitalization expenditure (per-time) dropped from 919.08 ± 274.92 USD to 834.91 ± 225.29 USD and length of hospital stay reduced from 9.96 ± 2.39 days to 8.83 ± 1.95 days(P < 0.01), after CP-based SDP had implemented. The yearly total hospitalization expenditure manifested an atypical U-shaped trend. Medicine expense, nursing expense, assay cost and treatment cost reduced; while the fee of operation and examination increased (P < 0.05). The expense constituent ratios of medicine, assay and treatment decreased with the medicine expense dropped the most (by 4.4%). The expense constituent ratios of materials, ward, operation, examination and anesthetic increased,with the examination fee elevated the most (by 3.9%).The coefficient of variation(CVs) of treatment cost declined the most (− 0.360); while the CV of materials expense increased the most (0.186). Conclusion There existed huge discrepancies in inpatient care for uterine leiomyoma patients. Implementation of CP-based SDP can help not only in controlling hospitalization costs of uterine leiomyoma in county-level hospitals but also in standardizing the diagnosis and treatment procedures

Research on Ranking Evaluation Models of Safety Risk in Productive Enterprises based on the Perspective of Supervision

AbstractSupervision with risk highlights the key area, enterprises and period. It is great for finding the principal contradiction in supervision of safe production, to improve the efficiency of government's regulation and further to realize the optimal configuration of the limited supervisory force from local government. This paper establishes the risk evaluation index system of incident and disaster for manufacturing enterprises based on the systematic investigation and analysis of 209 enterprises in T city, Shandong Province by referring to many research outcomes of scholars abroad and domestic, related laws and regulations and professional standards, choosing 6 B indexes which include 35C indexes according to the four characteristics and core objective of inherent risk level of manufacturing enterprise, safety regulation level, records of hidden dangers and punishments and accident occurrences. This paper also applies analytic hierarchy process(AHP) to determine the weight of every evaluation indexes, and make mathematics modelling according to the determined index system and weight, then use the model to evaluate and classify the risks of the 209 enterprises of T city Shandong Province, and finally propose measures of safety risk ranking supervision of production for local government according to the result of classification

Tensile Characteristics and Fracture Mode of Frozen Fractured Rock Mass Based on Brazilian Splitting Test

Frozen fractured rock mass is often encountered during the implementation of geotechnical engineering in cold regions. The tensile strength parameters of frozen rock play an important role in the construction of rock slopes involving tensile failure. In order to study the tensile characteristics of a frozen fractured rock mass in a cold region, original rock specimens were mined and processed in the Yulong Copper Mine, and artificial, frozen fractured marble specimens were made. The effects of different ice-filled crack angles, lengths, and widths on the force–displacement curve and the tensile strength of frozen rock were studied by laboratory Brazilian splitting experiments and RFPA3D, and the evolution law of the tensile strength of frozen rock was revealed. At the same time, wing crack initiation and cracking mode after tensile failure were analyzed by high-speed camera; the whole process of the Brazilian splitting of frozen rock was reconstructed, and the development of microcrack initiation in frozen rock was analyzed. The following conclusions were drawn from the test results: the frozen rock specimens have typical brittle-failure characteristics. The tensile strength of frozen rock decreases gradually with the increase in the width and length of ice-filled cracks, and decreases first and then increases with the increase in the angle of the ice-filled crack. The ice-filled crack incurs damage first, and then the wing cracks start from the tip of the ice-filled crack and extend continuously. The tensile strength of frozen rock is significantly affected by the angle and length of ice-filled cracks

Optimal dispatching of electric‐heat‐hydrogen integrated energy system based on Stackelberg game

Abstract The interest conflict among entities in the integrated energy system (IES) has a great challenge to operation decisions of IES. With regards to this, an optimal dispatching model of electric‐heat‐hydrogen IES based on Stackelberg game is proposed. Firstly, an energy producer (EP) model is formulated which considered the full utilization of hydrogen energy and involved the conversion of hydrogen energy to electricity and heat energy. Meanwhile, the demand response amount is integrated into the objective function of load aggregator (LA) in order to encourage consumers to adjust their consumption behaviour. Secondly, by analyzing the characteristics of price information interaction among EP, energy system operator (ESO), and LA, the payoffs of each entity in IES are reformulated. Finally, a Stackelberg game model is established with ESO as the dominator guiding price information, EP and LA as the followers whose private information is confidential. Genetic algorithm and quadratic programming algorithm (GA‐QP) are employed to solve the developed model. Numerical experiments are carried out on an actual park‐level IES in northern China to demonstrate the effectiveness of the proposed model in promoting the benefit equilibrium among various entities

Tensile Characteristics and Fracture Mode of Frozen Fractured Rock Mass Based on Brazilian Splitting Test

Frozen fractured rock mass is often encountered during the implementation of geotechnical engineering in cold regions. The tensile strength parameters of frozen rock play an important role in the construction of rock slopes involving tensile failure. In order to study the tensile characteristics of a frozen fractured rock mass in a cold region, original rock specimens were mined and processed in the Yulong Copper Mine, and artificial, frozen fractured marble specimens were made. The effects of different ice-filled crack angles, lengths, and widths on the force&ndash;displacement curve and the tensile strength of frozen rock were studied by laboratory Brazilian splitting experiments and RFPA3D, and the evolution law of the tensile strength of frozen rock was revealed. At the same time, wing crack initiation and cracking mode after tensile failure were analyzed by high-speed camera; the whole process of the Brazilian splitting of frozen rock was reconstructed, and the development of microcrack initiation in frozen rock was analyzed. The following conclusions were drawn from the test results: the frozen rock specimens have typical brittle-failure characteristics. The tensile strength of frozen rock decreases gradually with the increase in the width and length of ice-filled cracks, and decreases first and then increases with the increase in the angle of the ice-filled crack. The ice-filled crack incurs damage first, and then the wing cracks start from the tip of the ice-filled crack and extend continuously. The tensile strength of frozen rock is significantly affected by the angle and length of ice-filled cracks